In vitro osteogenic potential of an experimental calcium silicate-based root canal sealer

This in vitro study compared the cytotoxicity and osteogenic potential of an experimental calcium silicate-based sealer with an epoxy resin-based sealer (AH Plus; Dentsply Caulk, Milford, DE) and a zinc oxide-eugenol-based sealer (Pulp Canal Sealer; SybronEndo, Orange, CA).

Disks prepared from the respective sealer and from Teflon (negative control) were placed in direct contact with a MC3T3-E1 osteogenic cell line at 6 weekly intervals after immersion in a culture medium. Succinic dehydrogenase activities were evaluated using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. Extracts from these sealers after the 6-week immersion period were investigated also by MTT assay. Aged sealers were then switched to an osteogenic medium for examination of the alkaline phosphatase activity and mineralization of extracellular matrices produced by the differentiated cells.

All sealers exhibited severe toxicity after 24 hours, after which toxicity decreased gradually over the experimental period except for Pulp Canal Sealer, which remained severely toxic. Toxicity of the extracts derived from the sealers was concentration dependent, with those derived from the experimental sealer being the least cytotoxic at a 1:10 dilution. Minimal alkaline phosphatase activity and no bone formation were seen with Pulp Canal Sealer. The production of alkaline phosphatase was less intense for the experimental sealer at 7 days. However, both AH Plus and the experimental sealer did not inhibit mineralization of the extracellular matrix after 28 days.

The experimental calcium silicate-based sealer may be regarded as minimally tissue irritating and does not interfere with bone regeneration even when it is inadvertently extruded through the apical constriction.